Ben Barnard, a technician with Virginia Interventional Psychiatry, demonstrates the use of the Neurostar TMS Therapy System. Photo courtesy Virginia Interventional Psychiatry
Diagnosed with bipolar disorder and major depression when she was in her 20s, Susan Duffey had become tired of taking six to eight anti-depressant pills every day. Now 52 years old with a daughter in college, she decided to try a relatively new alternative therapy called Transcranial Magnetic Stimulation (TMS) at Virginia Interventional Psychiatry.
Duffey became the first patient to undergo 30 consecutive treatments at the outpatient clinic, which opened in March, using the NeuroStar TMS Therapy System. Approved by the U.S. Food and Drug Administration in 2008, the system incorporates a wire coil that creates a pulsed magnetic field.
"The magnetic field, in turn, generates a tiny electrical current in the brain," says Dr. William Sauvé, a psychiatrist with Virginia Interventional Psychiatry, located on Hickory Park Drive, off Nuckols Road in Glen Allen. The currents stimulate nerve cells in the brain that are involved in mood regulation. "It can reach about an inch below the scalp," Sauvé says. "This current is not something that can really be felt." Patients undergoing the procedure, which takes about 37 minutes per session, do not lose consciousness and they do not need anesthesia, he says. According to findings published in the journal Depression and Anxiety in 2012, researchers at Rhode Island's Butler Hospital and elsewhere confirmed that TMS therapy can be an effective alternative for patients whose symptoms are not relieved by antidepressant medications. "At first, I was cautiously optimistic about TMS," Duffey says. "It turned out to be the most positive experience while having this disorder, and the treatment is painless. After the treatment I experienced no side effects, stopped two medications, and cut my other medication doses in half. " The cost for the procedure ranges from approximately $300 to $600 per session, says Dr. Ananda Pandurangi, chairman of inpatient psychiatry at the VCU Medical Center and director of VCU's schizophrenia and Therapy programs. "VCU first used TMS as a research program in 2005," he says. "Thirty-six sessions is the standard procedure which patients should go through, only if they are not responding to antidepressant medications or psychotherapy. TMS is not the first line of treatment." Insurance providers such as Anthem Blue Cross/Blue Shield's Federal Employee Program, Optima Behavioral Health and Cigna VCU Health System ChoiceCare have policies with criteria for TMS treatment of depression. "Although the FDA indicates that patients can have TMS treatment after one failed trial of anti-depressant medication, for example taking Zoloft for four weeks, certain insurance companies require at least four failed medication treatments," Sauvé says. Duffey says her insurance covered her treatment. She adds, "The value of not popping antidepressant medications is actually invaluable compared to the TMS procedure." TMS treatments are provided locally by Tucker Psychiatric Clinic, VCU Medical Center and Virginia Interventional Psychiatry. "More insurance companies will cover TMS in the future," says Jay Nielson, TMS coordinator for the Tucker clinic, who notes that the number of patients opting for TMS therapy is on the rise. "Tucker Psychiatric is treating double the amount of patients versus this time last year."